摘要:

ABSTRACT. Larsson, A., Ljunggren, J. G., Ekman, K., Nilsson, A. and Olin, P. (Departments of Paediatrics and Child Psychiatry, Karolinska Institute, St. Goran's Children's Hospital; the Department of Medicine, St. Göran's Hospital; and the PKU Section of the Department of Bacteriology, National Bacteriological Laboratory, Stockholm, Sweden). Screening for congenital hypothyroidism. I. Laboratory results of a pilot study based on dried blood samples collected for PKU screening. Acta Paediatr Scand, 70:141, 1981. – A pilot study was performed to establish optimal conditions for nation‐wide screening for congenital hypothyroidism in Sweden. The levels of T4and TSH were determined by automated radioimmunoassay in the dried blood spots, routinely collected for PKU screening on the fifth postnatal day, from all 1979, 2 infants born in the Stockholm area during a 14‐month period. To identify safe minimum recall criteria for routine use, infants were recalled if the TSH level was more than 30 mU/l of plasma or–if they were not preterm–the T4concentration was less than ‐2 S.D. of the mean. Altogether 160 infants were recalled. Seven newborns with congenital hypothyroidism were identified, 6 with primary and one with secondary hypothyroidism. Five infants had decreased levels of thyroxine‐binding globulin. The results of the follow‐up analyses from recalled infants showed that determination of the reverse‐T3level may be of diagnostic value around the 23rd day of life. The results of the clinical investigation of recalled infants are reported in a subsequent paper and a programme for nation‐wide screening for congenital hypoth

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05532.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Larsson, A., Ljunggren, J. G., Ekman, K., Nilsson, A., Olin, P. and Bodegard, G. (Departments of Paediatrics and Child Psychiatry, Karolinska Institute, St. Göran's Children's Hospital; the Department of Medicine, St. Göran's Hospital; and the PKU Section of the Department of Bacteriology, National Bacteriological Laboratory, Stockholm, Sweden). Screening for congenital hypothyroidism. II. Clinical findings in infants with positive screening tests. Acta Paediatr Scand, 70:147, 1981.–In a pilot screening programme for congenital hypothyroidism, PKU filter paper blood samples from 20000 infants born in Stockholm were analysed for TSH and T4to identify optimal conditions for routine nationwide screening. Among 160 infants with positive screening tests, 7 infants (group I) had true‐positive results, 6 had primary and one secondary hypothyroidism. The 153 infants with false‐positive tests were divided into group II: 74 infants with an isolated increased TSH level; group III: 71 infants with an isolated decreased T4concentration; and group IV: 8 infants with increased TSH and decreased T4levels. In group I the clinical signs and symptoms of hypothyroidism varied when the diagnosis was made at 3 weeks of age. The median hypothyroid index score was 8 (range 0–18). In groups II‐IV most infants showed very few signs of hypothyroidism. The median hypothyroid index scores were 1,1, and 0, respectively. Clinical findings were of little value in the individual case for distinguishing true from false positive screening tests. We suggest that nation‐wide screening should be based on TSH analyses of PKU blood samples, with a cut‐off level corresponding to 50 mU/l of plasma. Recall frequenc

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05533.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Jacobsen, B. B., Hansted, L. C, Brandt, N. J., Haahr, J., Hummer, L., Munkner, T. and Sorensen, S. S. (Department of Paediatrics, Viborg Hospital, Children's Hospital Fuglebakken, Department of Paediatrics, Section of Clinical Genetics and Department of Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark). Thyroxine‐binding globulin deficiency in early childhood. Postnatal changes in serum concentrations of thyroid hormones and thyroid hormone‐binding proteins. Acta Paediatr Scand, 70:155, 1981. –Serial determinations of serum thyroxine (T4), triiodothyronine (T3), thyrotropin(TSH), thyroid hormone‐binding globulin (TBG), prealbumin (TBPA) and albumin were performed in a euthyroid girl with TBG deficiency and in her mother for a period of 22 months after delivery. At 8 days old the child had a serum TBG concentration around 50% of normal level which remained essentially unchanged during infancy. Total serum T4 and T3 concentrations were low, the free serum T4, free serum T3 and serum TSH concentrations were normal. The mother had received thyroid hormone from the age of 15 years. Her serum TBG level at 6 weeks post partum was similar to that of non‐pregnant adults but decreased to about 50% of normal level, indicating a TBG deficiency. She remained euthyroid after withdrawal of T4 therapy. Serum TBPA and albumin concentrations were normal in mother and child. An X‐linked inheritance of the TBG deficiency was suggested from a study of

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05534.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Dalens, B., Bezou, M. J., Raynaud, E. J., Coulet, M., and Gaulme, J. (Clinique Médicale Infantile and Laboratoire d'Hématologie, Hotel‐Dieu, Clermont‐Ferrand, France). Qualitative cytology of cerebrospinal fluid as an indicator of neonatal brain damage and psychomotor outcome. Acta Paediatr Scand, 70:161, 1981. –The authors report a double blind study on 57 full‐term neonates prospectively subjected to clinical, electroen‐cephalographical, cerebrospinal fluid and developmental examinations. Usual neonatal pleiocytosis depends on histiomonocytic cells which probably are a reflection of constant small brain damage during delivery. Infants suffering neurological sequelae at age one are recognizable as early as the 60th to 84th hours of life in view of persisting high histiomonocytic counts greater than 10 M. elements/1) and granulocytic peaks (greater than 2 M. elements/1) in clear samples. This method is then of interest, despite its invasive nature and limits (traumatic punctures, t

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05535.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Eeg‐Olofsson, O., Link, H. and Wigertz, A. (Departments of Neurology and Pediatrics, University Hospital, Linköping, Sweden). Concentrations of CSF proteins as a measure of blood brain barrier function and synthesis of IgG within the CNS in ‘normal’ subjects from the age of 6 months to 30 years. Acta Paediatr Scand, 70:167, 1981. –Concentrations of proteins in cerebrospinal fluid (CSF) and serum have been studied in 105 ‘normal’ subjects divided into age groups 0.5–5, 6–15, 16–20, and 21–30 years in order to obtain reference values for information concerning blood brain barrier damage and synthesis of immunoglobulins within the central nervous system (CNS). CSF/serum albumin ratio is superior to CSF total protein as a test of the blood brain barrier function. The IgG synthesis rate per 24 hours and IgG index [CSF/serum IgG ratio]: [CSF/serum albumin ratio]reflect the presence of IgG synthesis within the CNS. The variables reflecting the blood brain barrier function increased with age, the upper values of the CSF/serum albumin ratio being 4.0, 4.9, 6.7, and 6.5 for the mentioned age groups respectively. The upper values for the CSF IgG index reamined rather constant in relation to age at 0.62,0.68,0.64, and 0.63 respectively. An index value of less than 0.70 and an IgG synthesis of less than 10 mg/24 hours seem to be appropriate upper values as refereneces. Only about 1–2 ml of CSF and 0.5 ml serum are required for the analyses including cell counting and determinations of IgA and IgM index values as well as

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05536.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Sveger, T. and Thelin, T. (Departments of Paediatrics and Psychiatry, University of Lund, Malmö General Hospital, Malmö, Sweden). Four‐year‐old children with α1‐antitrypsin deficiency. Acta Paediatr Scand, 70:171, 1980. –Two hundred thousand infants born in Sweden between November 1972 and September 1974 were screened at birth for a,‐antitrypsin (a, AT) deficiency. At age 4 years 172 of 183 children with a, AT deficiency were examined and compared with 80 randomly selected control children. The children with a, AT deficiency had the following Pi types: 118 PiZ, 50 PiSZ, 2 PiZ‐, 1 PiS‐, and 1 PiFZ. Two PiZ children have severe liver cirrhosis and 1 PiZ boy had died of aplastic anemia. Abnormal levels of serum alanine aminotransferase (S‐ALAT) were found in one PiSZ and 47 PiZ children. Upper and lower respiratory infections, otitis, eczema, urinary infections or complications of child diseases did not occur more often in children with α1AT deficiency than in controls. More parents of α1AT deficient children had stopped smoking and their fathers smoked significantly less. Forty parents of children with α1AT deficiency PiZ answered a questionnaire concerning their reaction to, knowledge about and attitudes towards neonatal screening for α1AT deficiency. Many parents reported having reacted with lack of understanding, shock or depression upon learning that the child had α1AT deficiency. About 4 years later 44 % reported still lack of understanding, and 18 % depression or feelings of guilt. About two‐thirds had not fully understood whya, AT deficiency had been identified, despite the fact that they had seen their doctor 3–4 times for check‐up

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05537.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Raimbault. G. (Inserm U.158, Hôpital des Enfants Malades, Paris, France). Children talk about death. Acta Paediatr Scand, 70:179, 1981–As a psychoanalyst in a pediatric nephrology ward, I have listened to children talking about dying and death. As soon as a child can express himself freely on this subject, no further age‐dependent progress concerning the concept of death can be observed. Faced with disease and death, the child is led to the same images and conclusions, to the same order of ideas as the adult. This clearsightedness does not prevent the appearance of mechanisms of defence against the idea of death. Faced with the silence of the adult, the dying child shuts himself up in loneliness. However, the child does not want to be alone: he craves to be recognized. During the time left before his death, to be recognized is for him synonymous with: “to be recognized near death”. To let a child talk about his death is to let him talk about his life, to bring him the only possible help, that is, to be with him till

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05538.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Aperia, A., Broberger, B., Klinder, G., Herin, P. and Zetterström, R. (Department of Paediatrics, Karolinska Institute, St. Göran's Children's Hospital, Stockholm and Huddinge Hospital, Huddinge, Sweden). Postnatal deveopment of renal function in preterm and full‐term infants. Acta Paediatr Scand, 70:183, 1981. –This study has been designed to examine the effect of gestational age (GA) on the postnatal development of renal function and has been performed in pre‐term (PT) infants (GA=30–34 weeks) and in full‐term (FT) infants (GA=39–41 weeks). Postnatal age has ranged from 1–35 days. From 8 hour urine samples collected after spontaneous voiding and a capillary blood sample, determinations have been made of the clearance of creatinine (CCr), the fractional excretion of β2‐microglobulin (FEβ2) and the fractional excretion of sodium (FENa). In some infants receiving fluid parenterally, simultaneous determinations were made of the clearance of creatinine and inulin. As judged from this study, CCris a reliable indicator of the glomerular filtration rate (GFR). GFR was almost the same in newborn PT and FT, but from 0.3–1 week of age GFR increased significantly more rapidly in FT than in PT. From 1–5 weeks of age GFR increased at approximately the same rate in PT and FT infants. The absolute value for GFR in 3–5 weeks old infants was lower in PT than in FT. FEβ2was higher in PT than in FT infants during the entire first month of life and FENawas higher in PT than in FT infants during the first week of life, suggesting a glomerular tubular imbalance at least at the level of the proximal tubule in PT infants. It is concluded that different stages of maturation will alter the preconditions for the renal adaptation to extrauterine life during at least the first month of life. Therefore special attention must be paid to the limited renal function in PT during their

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05539.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Picciano, M. F., Calkins, E. J., Garrick, J. R. and Dcering, R. H. Foods and Nutrition Department, University of Illinois, Urbana, Illinois and Christie Clinic, Champaign, Illinois). Milk and mineral intakes of breastfed infants. Acta Paediatr Scand, 70:189, 1981.–Milk and mineral intakes of twenty‐six full term infants receiving human milk as their sole milk source were determined by “test weighing” and direct analyses of milk samples at months 1, 2 and 3 of lactation. Data indicate that volume of milk ingested ranged from 295 to 996 ml/day and mean intakes (606, 601, 626 ml/day at months 1, 2 and 3, respectively) are less than the often quoted 850 ml/day. Taking into account Swedish and Scottish data and that from the present investigation, it appears that typical human milk intakes are 500 to 800 ml/day. No relationship was observed between volume of intake and growth of infants. Ranges of intake for copper, iron, zinc, calcium, phosphorus, magnesium, sodium, potassium and chloride are comparable to values reported for these mineral intakes by both early and modern investigators even though different data collection techniques and analytical methods were e

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05540.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT. Lucas, A., Boyes, S., Aynsley‐Green, A. (Department of Paediatrics, John Radcliffe Hospital, Oxford) and Bloom, S. R. (Hammersmith Hospital, London, England). Metabolic and endocrine responses to a milk feed in six‐day‐old term infants: JMfferences between breast and cow's milk formula feeding. Acta Paediatr Scand, 70:195, 1981. – There is little information on the metabolic and endocrine responses to milk feeding in the neonatal period particularly in relation to the mode of nutrition and composition of the milk. Plasma concentrations of insulin, glucagon and gastric inhibitory polypeptide (GIP) together with blood levels of glucose, ketone bodies, pyruvate, lactate and glycerol were measured pre‐ and post‐prandially in 79 healthy six‐day‐old term infants who had been either breast fed or fed on a modified cow's milk formula (Cow and Gate Premium) from birth. Formula fed infants had a greater insulin and GIP response to feeding and their basal and postprandial blood ketones were considerably lower than in breast fed infants. In addition a significantly greater post feed rise in both lactate and pyruvate concentrations was observed with formula feeding. These results may have significant implications regarding infant feeding and postn

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1981.tb05541.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY